LongTerm Care HAIsCAUTI One or more of the following with no alternate source Fever Rigors shaking chills New onset hypotension with no alternate noninfectious cause ID: 695117
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Slide1
AHRQ Safety Program for
Long-Term Care: HAIs/CAUTISlide2
One or
more of the following, with no alternate
source:
□Fever*□Rigors (shaking chills)□New onset hypotension with no alternate non-infectious cause□New onset confusion/functional decline AND increased leukocytosis*□New costovertebral angle pain or tenderness□New or increased suprapubic pain or tenderness□Acute pain, tenderness, or swelling of the testes, epididymis, or prostate□Pus around the catheter insertion siteANDAny of the following:If catheter removed within past 2 calendar days:□Clean catch (voided) urine culture with no more than 2 species of microorganisms, at least 1 of which is bacteria of 100,000 or more colonies (≥105 CFU/ml)□In/Out catheter urine culture with any number of microorganisms, at least 1 of which is bacteria of 100 or more colonies (≥102 CFU/ml)If indwelling urinary catheter in place:□Positive urine culture with any number of microorganisms, at least 1 of which is bacteria >100,000 colonies (≥105 CFU/ml)
One or more of the following, with no alternate source:□Fever*□Rigors (shaking chills)□New onset hypotension with no alternate non-infectious cause□New onset confusion/functional decline AND increased leukocytosis*□New costovertebral angle pain or tenderness□New or increased suprapubic pain or tenderness□Acute pain, tenderness, or swelling of the testes, epididymis, or prostate□Pus around the catheter insertion siteANDAny of the following:If catheter removed within past 2 calendar days:□Clean catch (voided) urine culture with no more than 2 species of microorganisms, at least 1 of which is bacteria of 100,000 or more colonies (≥105 CFU/ml)□In/Out catheter urine culture with any number of microorganisms, at least 1 of which is bacteria of 100 or more colonies (≥102 CFU/ml)If indwelling urinary catheter in place:□Positive urine culture with any number of microorganisms, at least 1 of which is bacteria >100,000 colonies (≥105 CFU/ml)
One or more of the following, with no alternate source:□Fever*□Rigors (shaking chills)□New onset hypotension with no alternate non-infectious cause□New onset confusion/functional decline AND increased leukocytosis*□New costovertebral angle pain or tenderness□New or increased suprapubic pain or tenderness□Acute pain, tenderness, or swelling of the testes, epididymis, or prostate□Pus around the catheter insertion siteANDAny of the following:If catheter removed within past 2 calendar days:□Clean catch (voided) urine culture with no more than 2 species of microorganisms, at least 1 of which is bacteria of 100,000 or more colonies (≥105 CFU/ml)□In/Out catheter urine culture with any number of microorganisms, at least 1 of which is bacteria of 100 or more colonies (≥102 CFU/ml)If indwelling urinary catheter in place:□Positive urine culture with any number of microorganisms, at least 1 of which is bacteria >100,000 colonies (≥105 CFU/ml)
Catheter-Associated Urinary Tract Infection (CAUTI)
Criteria for defining CAUTI in long-term care residents:
Catheter-Associated Urinary Tract Infection (CAUTI)
Criteria for defining CAUTI in long-term care residents:
Catheter-Associated Urinary Tract Infection (CAUTI)
Criteria for defining CAUTI in long-term care residents:
Catheter-Associated Urinary Tract Infection (CAUTI)
Criteria for defining CAUTI in long-term care residents:
REV.
2016-Aug
REV.
2016-Aug
REV.
2016-Aug
REV. 2016-Aug
One or
more
of the following, with no alternate
source:
□
Fever*
□
Rigors (shaking
chills)
□
New
onset hypotension with no alternate non-infectious cause
□
New onset confusion
/
functional decline AND increased l
eukocytosis*
□
New costovertebral angle pain or tenderness
□
New or
increased suprapubic pain or tenderness
□
Acute pain, tenderness, or swelling
of the testes, epididymis, or prostate
□
Pus around the catheter insertion site
AND
Any of the following:
If catheter remove
d within past 2 calendar days
:
□
Clean
catch (v
oided
) urine culture with no more than 2 species of microorganisms, at least 1 of which is bacteria of 100,000 or more colonies (≥10
5
CFU/ml)
□
In/Out catheter urine
culture with any number of microorganisms, at least 1 of which is bacteria of 100 or more colonies (≥10
2
CFU/ml)
If indwelling
urinary
catheter in place:
□
Positive urine culture with any number of microorganisms, at least 1 of which is bacteria
>
100,000 colonies (≥10
5
CFU/ml)Slide3
*Constitutional Criteria for Long-Term Care Residents
Fever
+
Must have one of the following:□Single oral temperature >100°F (37.8°C)□□Repeated oral temperature >99°F (37.2°C)Repeated rectal temperature >99.5°F (37.5°C)□Single temperature >2°F (1.1°C) over baseline for oral or rectal+Presence of fever, even if due to another cause, should still be counted as part of meeting an infection definitionLeukocytosisMust have one of the following:□>14,000 white blood cells (leukocytes)/mm3□Increase in immature white blood cells (Left Shift) with >6% bands or >1,500 bands/mm3Acute Change in Mental Status (within last 7 days)All components must be present :□Confusion (with no alternate diagnosis and leukocytosis)□Fluctuating Behavior (comes and goes, or changes in severity)□Inattention (difficulty focusing and cannot maintain attention) □Disorganized thinking (thinking is incoherent or hard to follow) ORAltered level of consciousness (change is different from baseline, may be sleepy, lethargic, difficult to arouse)
Acute Functional Decline□New 3-point increase in total activities of daily living (ADL) score from baseline (range: 0-28)Each ADL scored from 0 (independent) to 4 (totally dependent), including: bed mobility, transfer, locomotion within facility, dressing, toilet use, personal hygiene, and eating*Constitutional Criteria for Long-Term Care ResidentsFever+Must have one of the following:□Single oral temperature >100°F (37.8°C)□□Repeated oral temperature >99°F (37.2°C)Repeated rectal temperature >99.5°F (37.5°C)□Single temperature >2°F (1.1°C) over baseline for oral or rectal+Presence of fever, even if due to another cause, should still be counted as part of meeting an infection definitionLeukocytosisMust have one of the following:□>14,000 white blood cells (leukocytes)/mm3□Increase in immature white blood cells (Left Shift) with >6% bands or >1,500 bands/mm3Acute Change in Mental Status (within last 7 days)All components must be present :□
Confusion (with no alternate diagnosis and leukocytosis)□Fluctuating Behavior (comes and goes, or changes in severity)□Inattention (difficulty focusing and cannot maintain attention) □Disorganized thinking (thinking is incoherent or hard to follow) ORAltered level of consciousness (change is different from baseline, may be sleepy, lethargic, difficult to arouse)Acute Functional Decline□New 3-point increase in total activities of daily living (ADL) score from baseline (range: 0-28)Each ADL scored from 0 (independent) to 4 (totally dependent), including: bed mobility, transfer, locomotion within facility, dressing, toilet use, personal hygiene, and eating*Constitutional Criteria for Long-Term Care ResidentsFever+Must have one of the following:□Single oral temperature >100°F (37.8°C)□□Repeated oral temperature >99°F (37.2°C)Repeated rectal temperature >99.5°F (37.5°C)□Single temperature >2°F (1.1°C) over baseline for oral or rectal+Presence of fever, even if due to another cause, should still be counted as part of meeting an infection definitionLeukocytosisMust have one of the following:□>14,000 white blood cells (leukocytes)/mm3
□
Increase in immature
white blood cells (Left Shift) with >6% bands or >1,500 bands/mm
3
Acute Change
in Mental Status (within last 7 days)
All components must be present :
□
Confusion (with no
alternate diagnosis and leukocytosis)
□
Fluctuating
Behavior (
comes and goes, or changes in severity)
□
Inattention (difficulty
focusing and cannot maintain attention)
□
Disorganized
thinking (thinking is incoherent or hard to follow)
OR
Altered level of consciousness (change is different from baseline, may be sleepy, lethargic, difficult to arouse)
Acute Functional Decline
□
New 3-point increase in total
activities of daily living (ADL) score from baseline (range: 0-28)
Each ADL scored from 0 (independent) to 4 (totally dependent), including: bed mobility, transfer, locomotion within facility, dressing, toilet use, personal hygiene, and eating
*Constitutional Criteria for Long-Term Care Residents
Fever
+
Must
have one of the following:
□
Single oral
temperature >100°F (37.8°C)
□□
Repeated
oral temperature >99°F (37.2°C)
Repeated
rectal temperature >99.5°F (37.5°C)
□
Single temperature >2
°F (1.1°C) over baseline for oral or rectal
+
Presence of fever, even if due to another cause, should still be counted as part of meeting an infection definition
Leukocytosis
Must have one of the following:
□
>14,000 white blood
cells (leukocytes)/mm
3
□
Increase in immature
white blood cells (Left Shift) with >6% bands or >1,500 bands/mm
3
Acute Change
in Mental Status (within last 7 days)
All components must be present :
□
Confusion (with no
alternate diagnosis and leukocytosis)
□
Fluctuating
Behavior (
comes and goes, or changes in severity)
□
Inattention (difficulty
focusing and cannot maintain attention)
□
Disorganized
thinking (thinking is incoherent or hard to follow)
OR
Altered level of consciousness (change is different from baseline, may be sleepy, lethargic, difficult to arouse)
Acute Functional Decline
□
New 3-point increase in total
activities of daily living (ADL) score from baseline (range: 0-28)
Each ADL scored from 0 (independent) to 4 (totally dependent), including: bed mobility, transfer, locomotion within facility, dressing, toilet use, personal hygiene, and eating